The correlation between neonatal parameters and late‐onset inner ear disorders in congenital cytomegalovirus infection: an 10‐year population‐based cohort study

xlomafota13 shared this article with you from Inoreader The correlation between neonatal parameters and late‐onset inner ear disorders in congenital cytomegalovirus infection: an 10‐year population‐based cohort study Via Clinical Otolaryngology Abstract Objective To evaluate the correlation of neonatal parameters with late-onset sensorineural hearing loss (SNHL) and vestibular dysfunction in individuals with congenital cytomegalovirus (cCMV) infection using the National Health Insurance Research Database (NHIRD) in Taiwan. Design Retrospective cohort study. Setting The whole Taiwanese population. Participants Patients with related diagnostic codes and examinations in their records were regarded as having cCMV infection. Each subject in that group was matched to 10 control individuals with noncongenital CMV infection on the basis of several neonatal parameters, including low gestational age, low birth weight, low Apgar score, maternal history of CMV infection and prolonged cCMV infection. A total of 5,893 and 58,930 participants were enrolled in the study and control groups, respectively. Main outcome measures The main outcomes were the development of SNHL and the development of vestibular dysfunction within one year after birth as reflected by diagnostic codes and specific examinations. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (HR) and 95% confidence interval (CI) of each primary outcome between the two groups. Results Overall, 109 and 397 episodes of SNHL developed in the study group and the control group, respectively, and the study group demonstrated a significantly higher incidence of SNHL (adjusted HR: 2.56; 95% CI: 2.07–3.18). In addition, similar incidence rates of vestibular dysfunction were found in the study group and the control group, with 7 and 90 events, respectively (adjusted HR: 0.77; 95% CI: 0.36–1.67). In subgroup analyses, a higher incidence of SNHL was correlated with lower gestational age (GA) (adjusted HR: 2.09; 95% CI: 1.29–3.39), lower birth weight (BW) (adjusted HR: 2.05; 95% CI: 1.28–3.30), and prolonged cCMV infection (adjusted HR: 3.92; 95% CI: 1.95–7.88). Conclusions Low GA, low BW and a long disease course are significantly correlated with late-onset SNHL in cCMV infection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis

xlomafota13 shared this article with you from Inoreader Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis Via Clinical Otolaryngology Abstract •Changes in the microvascular network of the nasal mucosa may be accompanied by changes in olfaction. •Contact endoscopic changes in the microvascular network of the nasal mucosa may be used as a marker of sinonasal sarcoidosis. •A modified version of the Negoro's classification, in use for the tongue mucosa, may be used for the classification of contact endoscopic microvascular patterns of the nasal mucosa in patients with sarcoidosis •The validation of the use of the vascular patterns of nasal mucosa on contact endoscopy as a marker of nasal disease activity is a major future research challenge •Contact endoscopy emerges as a promising technique for on-site diagnosis of early, advanced or late inflammatory mucosal spots or generalized mucosal affection in sarcoidosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cord Medialization in Unilateral Vocal fold paralysis improves forced vital capacity

xlomafota13 shared this article with you from Inoreader Cord Medialization in Unilateral Vocal fold paralysis improves forced vital capacity Via Clinical Otolaryngology Abstract Objective The lateralized vocal fold of unilateral vocal fold paralysis (ULVFP) is unphysiological for expiration wherein vocal folds normally adduct to increase expiratory resistance and prevent small airway collapse. ULVFP may therefore impair ventilatory function and ventilatory volume. This study seeks to test if vocal fold medialization improves forced vital capacity (FVC). Design Prospective inception cohort intervention study. Setting Academic Tertiary Care Institution. Participants Twenty-five patients of ULVFP with a phonatory gap ranging from 2-6 mm. Main outcome measures Vocal fold medialization undertaken with autologous fat injection. Forced Vital Capacity (FVC) assessments by spirometry undertaken pre-treatment and 1month post-treatment. Results Improvement in FVC noted in all patients with the quantum of improvement ranging from 0.1 to 0.6 liters. Mean FVC improved from 3.10 liters pre-injection to 3.45 liters post-injection. (p<0.001). A moderate correlation was noted between the degree of medialization and improvement in FVC (r=0.33, Pearson's Correlation Coefficient) Conclusion Objective improvement in FVC is consistently noted post vocal fold medialization for ULVFP, and is probably mediated by increased glottic expiratory resistance and consequent improvement in intrinsic PEEP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures

xlomafota13 shared this article with you from Inoreader Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures Via Clinical Otolaryngology Abstract Objectives In most cases, suspension laryngoscopy (SL) is efficient, bloodless and with minimal post-procedure discomfort. We aimed to identify predictive patient factors for acceptable surgical views at SL as well as quantify our tertiary airway unit's complication rates. Design Prospective cohort study of 150 consecutive microlaryngoscopy procedures involving SL over an 8-month period between November 2019 and July 2020. Patients were assessed pre-operatively for pre-existing oral, temporomandibular, dental, pharyngeal or laryngeal pathology, interincisor distance and qualitative gross limitations to neck extension and forward head posture. Intraoperatively, the laryngoscopic view was graded by anaesthetic and surgical teams, and complications were recorded on patient interview in recovery. Setting Tertiary adult airway service for predominantly benign pathology. Results Adequate surgical views were obtained in 149/150 procedures. BMI had a weak positive correlation with a more difficult view (r=0.22, p=0.008;) but did not correlate with a statistically significant increase in any complication. There was a weak negative correlation between age and interincisor gap (r=-0.20, p=0.014), and wider mouth opening correlated very weakly with a lower incidence of sore throat (r=-0.19, p=0.023). Gross macroglossia showed a significant moderate positive correlation with tongue symptoms (r=0.45, p=1.611x10-8). Conclusion In the context of an experienced airway unit with a high caseload of predominantly benign pathology, SL is very effective and safe with low associated morbidity and no mortality. The most common complication of SL is temporary sore throat and there remain recognised risks of temporary tongue and dental symptoms. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predisposing factors of rhino-orbital-cerebral mucormycosis in patients with COVID 19 infection

xlomafota13 shared this article with you from Inoreader Predisposing factors of rhino-orbital-cerebral mucormycosis in patients with COVID 19 infection Via Otolaryngology Indian Abstract The predisposing factors of invasive fungal disease in COVID 19 infection are still debatable because of the limited human understanding of the virus with the current literature. In this study, we have tried to correlate the various predisposing factors influencing the clinical profile and treatment outcomes in patients with covid associated mucormycosis (CAM). It is a retrospective analysis of cases of CAM during the second wave of COVID 19 infection, which was managed in the department of Otorhinolaryngology from Dec 1, 2020, to June 10, 2021. The detailed clinical, radiological and management of patients with CAM were collected, recorded, evaluated and correlated with the predisposing factors. Of the total, 46 patients, 44(95.65%) were diabetic and 41 patients had a previous history of steroid intake. When clinical parameters were compared between blood sugar < 200 mg/dl and > 200 mg/dl, the old and newly diagnosed diabetes mellitus in patients with CAM, there was no significant differences in any of the above clinical parameters (p > 0.05), except the hospital stay (p = 0,004). Steroid intake in patients with coexisting DM associated with CAM is considered the most important factor for the development of the CAM. There was are no significant difference in any of the clinical/treatment outcomes in patients with CAM with respect to the initial blood sugar, except for the hospital stay. A large sample size with a long-term follow-up period may be needed for a better understanding of common predisposing factors for the development of CAM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radioactive Particle Implantation Combined with Chemotherapy for Treatment of Pancreatic Adenocarcinoma

xlomafota13 shared this article with you from Inoreader Radioactive Particle Implantation Combined with Chemotherapy for Treatment of Pancreatic Adenocarcinoma Via radioactive iodine Radiol Imaging Cancer. 2021 Sep;3(5):e219020. doi: 10.1148/rycan.2021219020. NO ABSTRACT PMID:34533374 | DOI:10.1148/ryca n.2021219020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

xlomafota13 shared this article with you from Inoreader Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments Via Head & Neck Abstract Background To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. Results The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085–0.979]) and anterior (HR = 0.278 [0.128–0.605]) and posterior (HR = 0.269 [0.115–0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1.537–8.495]) and posterior (HR = 5.195 [2.167–12.455]) PGS involvement were independent factors of total laryngectomy. Five-year OS, DSS, and LFS rates were 63.9%, 77.5%, and 77.5%, respectively. Patients with posterior PGS presented a reduced 5-year LFS. Conclusions Tumor classification according to laryngeal compartmentalization depicts strong correlation with LC and LFS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of enhancer RNAs for the prognosis of head and neck squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Identification of enhancer RNAs for the prognosis of head and neck squamous cell carcinoma Via Head & Neck Abstract Background Enhancer RNAs (eRNAs) play an important role in carcinogenesis. The landscape of eRNAs in head and neck squamous cell carcinoma (HNSCC) remains largely unknown. Methods The eRNA expression matrix was obtained from the enhancer RNA in the cancer database. Functional enrichment analyses were performed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG). Prognostic eRNAs were identified using Cox regression analysis, and a prognostic prediction model was constructed based on coefficients. Results KEGG analysis showed that eRNA-related transcription factors were mainly enriched in herpes simplex virus 1 (HSV1) infection. The zinc finger (ZNF) family may play an essential role in HNSCC. ENSR00000188847, ENSR00000250663, ENSR00000313345, ENSR00000317887, and ENSR00000336429 were identified. The prediction model was robust. Conclusions We constructed a robust 5-eRNA prognostic prediction model, and these eRNAs are potential biomarkers for HNSCC prognosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hidden intra-meatal CSF fistula related to VP shunt as a cause for fatal tension pneumocephalus after vestibular schwannoma resection

xlomafota13 shared this article with you from Inoreader Hidden intra-meatal CSF fistula related to VP shunt as a cause for fatal tension pneumocephalus after vestibular schwannoma resection Via leak of cerebrospinal fluid Br J Neurosurg. 2021 Sep 28:1-6. doi: 10.1080/02688697.2021.1981240. Online ahead of print. ABSTRACT BACKGROUND: Cerebrospinal fluid (CSF) leak through petrosal air cells is a known complication after drilling the posterior wall of the internal acoustic canal (IAC) for resection of vestibular schwannoma (VS). Whereas mild pneumocephalus is common after retrosigmoid craniotomy, tension pneumocephalus has been rarely documented. OBJECTIVE: To testify a case of fatal tension pneumocephalus after VS resection in a patient with ventriculo-peritoneal (VP) shunt and to propose possible recommendations to limit the risk of this dramatic complication. METHODS: A case of fatal tension pneumocephalus after VS resection in presence of hidden CSF fistula is illustrated with pre- and post-operative images. RESULTS: In the uneventful situation of concomitant post-operative CSF fistula in presence of VP shunt, tension pneumocephalus may occ ur. The negative pressure created by the shunt system and the presence of osteo-dural defect allow the air to enter and, at the same time, prevent the outflow. CONCLUSION: After VS resection, tension pneumocephalus can occur as a consequence of CSF fistula from petrosal air cells in the presence of functioning VP shunt. Precautions as pre-operative increase to 'virtual-off' the pressure of the valve, subsequences CT scans after surgery and sealing of the petrous air cells are recommended to avoid such as fatal complication. PMID:34579610 | DOI:10.1080/02688697.2021.1981240 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Variability in Thyroid Cancer Multidisciplinary Team Meeting Recommendations Is Not Explained by Standard Variables: Outcomes of a Single Centre Review

xlomafota13 shared this article with you from Inoreader Variability in Thyroid Cancer Multidisciplinary Team Meeting Recommendations Is Not Explained by Standard Variables: Outcomes of a Single Centre Review Via radioactive iodine J Clin Med. 2021 Sep 15;10(18):4150. doi: 10.3390/jcm10184150. ABSTRACT Multidisciplinary team (MDT) meetings are the mainstay of the decision-making process for patients presenting with complex clinical problems such as papillary thyroid carcinoma (PTC). Adherence to guidelines by MDTs has been extensively investigated; however, scarce evidence exists on MDT performance and variability where guidelines are less prescriptive. We evaluated the consistency of MDT management recommend ations for T1 and T2 PTC patients and explored key variables that may influence therapeutic decision making. A retrospective review of the prospective database of all T1 and T2 PTC patients discussed by the MDT was conducted between January 2016 and May 2021. Univariate analysis (with Bonferroni correction significance calculated at p < 0.006) was performed to establish clinical variables linked to completion thyroidectomy and Radioactive iodine (RAI) recommendations. Of 468 patients presented at thyroid MDT, 144 pT1 PTC and 118 pT2 PTC met the selection criteria. Only 18% (n = 12) of pT1 PTC patients initially managed with hemithyroidectomy were recommended completion thyroidectomy. Mean tumour diameter was the only variable differing between groups (p = 0.003). pT2 patients were recommended completion thyroidectomy in 66% (n = 16) of instances. No measured variable explained the difference in recommendation. pT1 patients initially managed with total thyroidectomy were not recommended RAI in 71% (n = 55) of cases with T1a status (p = 0.001) and diameter (p = 0.001) as statistically different variables. For pT2 patients, 60% (n = 41) were recommended RAI post-total thyroidectomy, with no differences observed among groups. The majority of MDT recommendations were concordant for patients with similar measurable characteristics. Discordant recommendations for a small group of patients were not explained by measured variables and may have been accounted for by individual patient factors. Further research into the MDT decision-making process is warranted. PMID:34575260 | DOI:10.3390/jcm10184150 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Accuracy of cancer diagnostic probe (CDP) for intra‐surgical checking of cavity side margins in neoadjuvant breast cancer cases; A human model study

xlomafota13 shared this article with you from Inoreader Accuracy of cancer diagnostic probe (CDP) for intra‐surgical checking of cavity side margins in neoadjuvant breast cancer cases; A human model study Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Recently, a real-time system, named cancer diagnostic probe (CDP), has been developed to diagnose the presence of pre-neoplastic/neoplastic cells in breast cavity side margins. Detecting mechanism is real-time determination of the ROS/H2O2 released from cancer or atypical cells, through reverse Warburg effect and hypoxia glycolysis pathways. Here we designed a human model study based on real-time checking of 387 internal margins from 39 neoadjuvant breast cancer cases by CDP. The permanent pathology results of tested lesions were our gold standard to evaluate CDP scoring. CDP results were compared with permanent pathology of tumor side margins (as a conventional margin evaluation procedure). Results showed that the sensitivity of CDP in scoring the cavity side margins of those cases is 91%. 18 involved internal margins which had been detected by CDP were declared as free margins in pathology section of tumor side samples. Just 5 involve d internal margins were missed by CDP. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inpatient Sinus Surgery Patient Morbidity and Outcomes: A National Analysis

xlomafota13 shared this article with you from Inoreader Inpatient Sinus Surgery Patient Morbidity and Outcomes: A National Analysis Via The Laryngoscope Objectives/Hypothesis To investigate the morbidity and mortality of patients undergoing endoscopic sinus surgery (ESS) in the inpatient setting. Study Design Retrospective database review. Methods The Nationwide Inpatient Sample was queried for all ESS between 2008 and 2014. Using All Patients Refined Diagnosis Related Groups (APR-DRG) codes, cases with APR-DRG codes under Major Diagnostic Category 3 (Diseases and Disorders of the Ear, Nose, Mouth, and Throat) were designated as patients with primary otolaryngology diagnoses undergoing ESS (ORL), and all other codes were designated as patients with non-otolaryngology pathologies as their primary reason for admission but undergoing ESS (non-ORL). A univariate analysis and a logistic regression were used to compare patient demographics, comorbidities, disease severity, and mortality. Results There were 8,305 ORL patients and 6,342 non-ORL patients. ORL patients were more likely to be elective admissions (61.3% vs. 48.5%, P < .001), have a deviated nasal septum (17.9% vs. 12.3%, P < .001), nasal polyps (15.8% vs. 5.0%, P < .001), obstructive sleep apnea (10.7% vs. 5.2%, P < .001), and pulmonary disease (15.9% vs. 10.5%, P < .001). Non-ORL patients had a higher likelihood of in-hospital mortality (odds ratio [OR] 6.22, 95% confidence interval [CI] 3.29–11.78, P < .001), length of stay in the highest quartile (OR 2.43, 95% CI 2.16–2.74, P < .001), and a higher proportion had APR-DRG subclasses indicating extreme severity of illness (19.3% vs. 4.3%, P < .001) or extreme risk of mortality (12.5% vs. 2.0%, P < .001). Conclusion Patients undergoing ESS in the inpatient setting have a higher than expected mortality rate which can be associated with a non-otolaryngology pathology as the primary reason for their admission. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.